Reissue: NIDCR-CTSA Clinical and Translational Science Training Partnership Program

September 2021

Research Training and Career Development Branch
Division of Extramural Activities

Goal

The translation of basic research discoveries to implementing interventions that improve public health requires teams of scientists, clinicians, and other stakeholders with wide-ranging expertise and perspectives. The National Center for Advancing Translational Sciences (NCATS) Clinical and Translational Science Award (CTSA) Program is designed to develop innovative solutions to accelerate the processes of diagnoses, discovery, and dissemination of research findings, drugs, and interventions to the public. The goal of this initiative is to leverage the research training resources and expertise available in the network of the NCATS’ CTSA Program supported medical research institutions (“hubs”) to increase the pipeline of NIDCR early career investigators who can advance clinical and translational dental, oral, and craniofacial research.

Background

One of the over-arching goals of the CTSA Program is to promote team science and the development of a well-trained and skilled translational research workforce. Early exposure to collaborations leveraging disparate areas of expertise will better prepare clinical investigators to tackle current and emerging challenges facing clinical research.

CTSA Program hubs are defined as a UL1 award with a linked KL2 award and optional TL1 award. The KL2 Mentored Career Development Award offers formal research training experiences to scholars who have an MD, DDS, DMD, PhD or equivalent doctoral degrees. The program combines formal course work with direct research experience, and many institutions’ programs offer opportunities to pursue additional advanced degrees. All students, including those at CTSA partner institutions, have access to CTSA research facilities, which may include:

• Training courses, seminars, and workshops.
• Use of specialized equipment and databases.
• Access to clinical research mentor expertise.
• Administrative and regulatory support for research protocols.
• Funding for pilot research projects.

KL2 awards support 2-5 years of mentored research career development at a minimum of 75% research effort for individuals who have recently completed professional training and for those who are beginning basic, translational, and/or clinical research. The CTSA-KL2 funded institutions select KL2 scholars, providing them with a rich career development experience in an interdisciplinary setting. KL2 appointees, referred to as Clinical Research KL2 Scholars, come from a variety of fields, such as medicine, dentistry, nursing, the behavioral sciences, biostatistics, and epidemiology. The KL2 Program offers opportunities for scholars to explore novel research experiences with industry, community health centers, and federal partners (FDA, VA). KL2 awards are intended to provide a foundation for KL2 scholars to transition to independent research funding.

A modest number of dentist scientists have participated in the KL2 program as Clinical Research KL2 Scholars. Twelve of 1,233 KL2 Scholars supported 2006-2013 had a dental degree (DDS, DMD, or BDS). To address the low participation by dentist scientists and dental, oral, and craniofacial scientists, in 2017, NIDCR initiated a pilot program with NCATS: RFA-DE-17-008 “Limited Competition: NIDCR Supplements to NCATS CTSA Programs for Scholars Pursing Dental, Oral, and Craniofacial Clinical and Translational Research Career Development (Admin Supp)”, with the goal to increase the number of dentist scientists and other early career investigators pursuing dental, oral, and craniofacial research who participate in, and benefit from, the formal training, research experiences, and available resources as Clinical Research KL2 Scholars. Eligible scholars were experienced investigators and clinical scientists at the postdoctoral and junior faculty levels.

The pilot NIDCR-CTSA Training Partnership Program offered a unique pathway for early career investigators in dental, oral, and craniofacial research to participate in the CTSA program as Clinical Research KL2 Scholars. The intent of the pilot was to stimulate interest in translational science, to immerse early career investigators in the core principles and skills required to advance research in translational science, to foster team science across a broad range of scientific disciplines, and to augment the development of a well-trained and skilled dental, oral, and craniofacial translational research workforce. NIDCR supported scholars would obtain an individualized program of translational science education, research training, and career guidance that leverages the infrastructure support, curriculum, and mentorship expertise of the CTSA program.

In addition, the RFA was responsive to one of the recommendations put forth in the Physician-Scientist Workforce Working Group Report, June 2014 on ways to enhance and maintain the U.S. physician-scientist, dentist-scientist, nurse-scientist, and veterinarian-scientist pipeline. The recommendations include to “Leverage the existing resources of the CTSA Program to obtain maximum benefit for training and career development”. The report encourages optimal use of CTSA resources, innovative pilot programs, and extending the resources to non-MD components of the PSW. Specific recommendations for the dentist-scientist workforce include “encourage/incentivize promising dental school graduates to consider careers in developing team science perhaps by creating post-doctoral fellowships-faculty transition plans at their school with post-doctoral fellowships to be performed at leading centers for team science”.

Outcomes

NIDCR received 15 applications submitted by 10 universities in response to RFA-DE-17-008. NIDCR funded five awards in 2017 (Table 1). Scholars requested two or three years of KL2 support.

Table 1. NIDCR KL2 scholars, program characteristics, and outcomes.

Outcomes of the NIDCR pilot KL2 program include:

• 4/5 (80%) scholars were dual degree DDS/DMD PhD scientists.
• 4/5 (80%) scholars remain in research intensive positions.
• 1/5 (20%) scholar accepted a research related position in industry.
• 1/5 (20%) scholars transitioned to a K23, shortening KL2 support.

All NIDCR Clinical Research KL2 Scholars remain in research intensive and research related positions. NIDCR KL2 scholars in research intensive positions are actively seeking independent research funding from NIDCR (data not shown). In addition to career outcomes, competing successfully for NIH grants demonstrates potential for establishing independently funded research careers. The success of the NIDCR KL2 scholars in transitioning to individual K awards and subsequent research project grants (RPGs) is compared to subsequent grant awarded to NIDCR mentored K08 and K23 awardees (Table 2). The K08 and K23 are mentored career development awards for early career clinician scientists at the postdoctoral and junior faculty levels and provide 3-5 years of “protected time” (75% minimum effort) for research career development in biomedical or behavioral research and translational research (K08) and in patient-oriented research (K23).

Table 2. Percent of mentored K awardees (KL2, K08, K23) awarded individual NIH grants during or after mentored K support.

The subsequent grant outcomes for the NIDCR KL2 and K23 awardees are similar in the percent of individuals awarded RPGs (KL2 60%, K23 52%) and R01s or equivalent awards (KL2 40 % and K23 39%). The percent of NIDCR KL2 and K08 awardees obtaining RPGs is similar to subsequent grant outcomes of KL2 scholars (n=952, 2006-2014) in which 49% of scholars were awarded grants from NIH and other federal agencies (Sorkness, et al., 2019).

Gaps and Opportunities

Historically, KL2 scholars from dentistry have low representation in CTSAs compared with KL2 scholars from medicine (Sorkness, et al., 2019). The proposed NIDCR-CTSA Training Partnership Program fills a gap in the NIDCR research training portfolio by providing a unique opportunity to stimulate interest in translational science to enhance participation of dentist scientist as KL2 scholars, and to increase participation by individuals with expertise in oral health on interdisciplinary teams of clinical and translational investigators.

NIDCR currently supports several research training and career development awards for individuals who have completed their professional clinical and/or academic doctoral degrees and are seeking mentored research experiences to support their transition to research independence. These awards include individual awards (Fs, Ks) and institutional awards (T32, T90, R90, K12 DSPP), where the Program Director of the grant selects trainees. The awards require either 100% research effort (F32, T32, T90, R90) or a minimum of 75% research effort (KL2, K12, Ks). The descriptions of programs and research training for postdoctoral scientist, junior faculty, and clinicians are available at NIDCR Careers & Training.

Specific Areas of Interest

The outcomes of the NIDCR-CTSA Training Partnership Program RFA-DE-17-008 demonstrate NIDCR KL2 scholars’ continuation of research intensive and research related careers after KL2 support has ended. Their success in obtaining subsequent research project grants (60%) suggests that the program attracts scholars who successfully leverage CTSA resources and successfully compete for independent funding. The number of applications received in response to the RFA demonstrates a strong interest, a robust response, and a need for the NIDCR KL2 Career Development Program. The KL2 Career Development Award Program requires a minimum of 75% research effort, which allows junior faculty scholars to use 25% effort to perform clinical, teaching, or other administrative responsibilities supported by their academic department or university. Reissuing the NIDCR NCATS partnership program to co-fund NCATS KL2 (or future CTSA K12 awards, see NOT-TR-21-030) to support dentist scientists and other dental, oral, and craniofacial postdoctoral researchers is an opportunity to build upon the success of the initial NIDCR-CTSA KL2 partnership, leverage the expertise at existing CTSA hubs, and continue to develop the pipeline of NIDCR clinical and translational research investigators. Participation by dentist scientists would expand the scope of clinical perspectives on interdisciplinary teams of clinical and translational investigators. Eligible dentist scholars are expected to include individuals with a DDS/DMD, with or without a Master’s degree (e.g., MPH, Master in Epidemiology), a PhD, and/or other equivalent Master’s or research doctoral degree(s).

The aim of the NIDCR-NCATS partnership program is to immerse scholars in the core principles and skills required to advance research in translational science through the CTSA consortium, to foster team science across a broad range of scientific disciplines and augment the development of a well-trained and skilled translational dental, oral, and craniofacial research workforce. Eligible CTSA KL2/K12 awards are expected to have sufficient time remaining on the grant to support an NIDCR KL2/K12 scholar for a minimum of two years of personalized training. NIDCR scholars are expected to have a minimum of one KL2/K12 mentor aligned with dental, oral, and craniofacial research, and another KL2/K12 mentor who can support the scholar’s development in clinical and translational research, team science, or other CTSA Hub topic areas to advance the scholar’s research program. NIDCR scholars are expected to have a minimum of one KL2 mentor aligned with dental, oral, and craniofacial research, and another KL2 mentor who can support the scholar’s development in clinical and translational research, team science, or other CTSA Hub topic area(s) to advance the scholar’s research program.

References

• NCATS Advisory Council Working Group on the IOM Report: The CTSA Program at NIH A Working Group of the NCATS Advisory Council to the Director Draft Report. May 16, 2014.
• The CTSA Program at NIH: Opportunities for Advancing Clinical and Translational Research (2013). Institute of Medicine of the National Academies
• Physician-Scientist Workforce (PSW) Report. June 2014
• Sorkness CA, Scholl L, Fair AM, Umans JG. KL2 mentored career development programs at clinical and translational science award hubs: Practices and outcomes. J Clin Transl Sci. 2019 Dec 26;4(1):43-52. doi: 10.1017/cts.2019.424. PMID: 32257410; PMCID: PMC7103475.

NOTE: To view a list of CTSA Program awards, click on underlined dollar amounts in the table (PDF - 110.31KB). For a list of CTSA Program hubs, select the underlined dollar amount in the row labeled “Hub Awards” (a UL1 award with a linked KL2 award and an optional TL1 award). This will open a list of search results in NIH RePORT.